Practices should look to work at scale and form networks to create sustainability and ‘collaborative resilience’, Dr Nagpaul said.
Speaking at a Westminster Health Forum event, he said the 2016/17 GP contract represented an ‘important and critical juncture’ for general practice.
‘The most important thing at this moment in time is to create these collaborative structures – I call them networks to encompass federations and other GP provider organisations – to provide support so practices can continue to function,’ he said.
‘The current contract already has a flexibility for practices to work together, share staff, share services and provide cross-cover when one practice is down, [but] we’re not exploiting that flexibility in the contract. It’s something we really need to be doing much more of.
‘And that will be much easier if there was a formalised network arrangement that provided management support so all practices were trained and prepared for a CQC inspection, had back office functions and support.’
He described workload as ‘the biggest reason’ why GPs are leaving the profession and trainees are reluctant to opt for general practice.
‘What GPs want is a limit to workload. Many areas are now looking at overspill arrangements so practices can transfer patients to be seen at a local hub. Urgent care, home visits and telephone triage can be done on behalf of several practices, and these sorts of models are being explored and it’s something we think could help.’
Moving on to talking about managing transfer of workload out of hospitals, he added: ‘At the moment, there is no buffer. You’ve got hospitals just transferring work down to practices.
‘A network provides a hub, it provides a buffer so that that workload can be commissioned and managed – the transfer of workload out of hospitals can be managed in an appropriate way. And that can also be, with the prerequisite funding, an arrangement for individual practices to play their part should they wish to do so.
‘This is happening already – but haphazardly. Whether it’s creating super partnerships, federations, devo manc and devo others – we know there’s a bottom-up and national approach to working at scale. We believe that the national core contact is entirely consistent with working at scale.’